A Study on post-operative radiographic factors and patient reported outcome following Total Hip Arthroplasty(THA).

Thamizharasan, L (2015) A Study on post-operative radiographic factors and patient reported outcome following Total Hip Arthroplasty(THA). Masters thesis, Madurai Medical College, Madurai.

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Abstract

INTRODUCTION: Total Hip Replacement is recommended for elderly patients with displaced Fracture neck of femur.Although Total Hip Replacement (THR) is a very successful surgical intervention, some patients experience persistent pain or dissatisfaction with outcome of surgery. Implant positioning is a major factor in the post - operative outcome of Total Hip Arthroplasty. Lewinnek et al proposed safe zone of cup anteversion as 15°±10° (AV) and cup alignment as 40°±10°.Combined anteversion of 25 to 50 degrees is the safe zone.Our aim is to determine whether post-operative radiographic variables are predictive of patient-reported pain, function and satisfaction after primary THR. AIM: The aim of the study is to analyse the clinical and radiological outcome following uncemented THA in neck of femur fractures. METHODS: In our study we analysed 40 cases of THA,with 30 cases of fresh displaced fracture neck of femur and 10 cases of Non union neck of femur in the age group of 50 to 76 years.This study is a prospective study conducted between September 2012 to September 2014 with a follow up of minimum 6 months to 2 years. All patients were taken X-rays and CT scan to measure Cup version,Cup Offset,Limb length discrepancy,femoral stem alignment ,Stem version and Combined Anteversion.The post-operative radiographic variables were statistically analysed with Modified Harris Hip score to find any significant difference in functional outcome. RESULTS: In our study it was found that offset restoration,leg length restoration,femoral stem alignment and acetabular inclination are not significant significant predictors of functional outcome following THR.It was found that there exists both statistically and clinically significant difference in functional outcome based on Modified Harris hip score with changes in CT-anteversion and combined anteversion values. Of 40 cases analysed 10 patients excellent ,18 good,6 fair and 6 poor outcome.CT-scan of 6 patients with poor outcome shows retroversion of cup and 3 patients showed an impinging lesion over iliopsoas. CONCLUSION: Implant position especially Cup version and Combined anteversion of cup and stem is a critical factor in both short-term and long-term outcome of patients with Total hip Arthroplasty.Retroversion of cup is a major cause of impingement and thus pain after THR.CT scan is the best method to find version of cup and stem and thus combined anteversion.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Harris hip score ; combined anteversion ; retroversion.
Subjects: MEDICAL > Orthopaedics
Depositing User: Subramani R
Date Deposited: 25 Sep 2017 02:26
Last Modified: 25 Sep 2017 02:26
URI: http://repository-tnmgrmu.ac.in/id/eprint/3316

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